Spontaneous Expulsion of a Huge Cervical Fibroid After Uterine Artery Embolization Done as a Lifesaving Procedure for Acute Severe Abnormal Uterine Bleeding

Abstract

Uterine fibroids are a prevalent disease that most commonly affects women of reproductive age group and causes symptoms such as abnormal uterine bleeding that can have a detrimental impact on their quality of life. Being in the reproductive age group, fertility-conserving modalities in the form of hormonal therapy, myomectomy, hysterectomy, and uterine artery embolization (UAE) remain the main treatment options. Uterine artery embolization is one of the treatment options for select cases of fibroid uterus. Here, we present the case of a 36-year-old woman diagnosed with cervical leiomyoma who presented with uncontrollable uterine bleeding, severe anemia, and many failed medical therapies. Although the case did not fit within the usual UAE guidelines, the treatment was done to tide over the crisis as a temporary method to control severe hemorrhage. Bleeding was controlled immediately and the patient was getting prepared for major surgery with the correction of severe anemia. However, seven days after UAE, the fibroid spontaneously expelled itself, resulting in improved symptoms and the avoidance of surgery. The patient is currently symptomless and has improved sexual life, self-esteem, and quality of life.